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Privacy Practices
NOTICE OF PRIVACY
PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL
INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO
THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY. THE PRIVACY OF YOUR
MEDICAL INFORMATION IS IMPORTANT TO US.
Our Privacy Promise
We will keep your medical information private. We will also give you this
notice about our privacy practices, our legal duties and your rights concerning
your medical information. We will follow the privacy practices that we describe
in this notice while it is in effect. This notice took effect April 14, 2003,
and will remain in effect until it is changed or replaced.
We reserve the
right to change our privacy practices and the terms of this notice at any time,
as long as the law allows. We reserve the right to make these changes
effective for all medical information that we keep, including medical
information we created or received before we made the changes. Before we make a
significant change in our privacy practices, we will change this notice and send
the new notice to you prior to the effective date of the change.
Uses and Disclosures of Medical Information
Treatment, Payment, Health Care Operations
We may use and disclose your medical information for purposes of treatment, payment and health care operations.
For example:
Treatment: We may disclose your medical
information to a physician or other health care professional so they can treat
you.
Payment: We may use and/or disclose your medical information
for these and other related activities:
- To pay claims from physicians, hospitals and other health care professionals
for covered services you received.
- To determine your eligibility for benefits.
- To coordinate those benefits.
- To determine medical necessity.
- To obtain premiums.
- To issue explanations of benefits to the named insured.
We may disclose your
medical information to a health care professional or entity that is bound by the
federal Privacy Rules so they can obtain payment or engage in payment
activities.
Health Care Operations: We may use and/or disclose your
medical information in the normal course of our health care operations. This
includes:
- Determining our risk and premiums for your health plan.
- Quality assessment and improvement activities.
- Reviewing the qualifications of health care professionals; evaluating
practitioner and provider performance; conducting training programs; and
accreditation, certification, licensing and credentialing activities.
- Medical review, legal services and auditing, including fraud and abuse
detection and compliance programs.
- Business planning and development.
- Business management and general administrative activities, including
management activities relating to privacy, customer service, internal
grievances and creating de-identified information or a limited data
set.
We may disclose your medical information to another entity,
which has a relationship with you and is also bound by the federal Privacy Rules,
for its health care operations relating to quality assessment and improvement
activities, reviewing the competence or qualifications of health care
professionals, or detecting or preventing health care fraud and
abuse.
Your Authorization
You may give us written authorization
to use your medical information or to disclose it to anyone for any purpose. You
may revoke your authorization in writing at any time. However, this will not affect any
uses and disclosures that your authorization allowed while it was in effect.
Without your written authorization, we will not use or disclose your
medical information for any reason except those described in this
notice.
Your Family and Friends
We may disclose your medical
information to a family member, friend or other person to the extent necessary
to help with your health care or with payment for your health care. We may use or disclose
your medical information to notify (or help notify, including identifying and locating) a
family member, a personal representative or other person responsible for your care of your
location, general condition or death.
Before we disclose your medical information to that person, we will give
you a chance to object to us doing so. If you are not available, or if you are
incapacitated or in an emergency situation, we will disclose your medical
information based on our professional judgment of what would be in your
best interest.
Your Employer or Organization Sponsoring Your Group
Health Plan
We may disclose summary information about you to your employer
or plan sponsor for two reasons. One is to get premium bids for
the health insurance coverage offered through your group health plan. The second
is to decide whether to modify, amend or terminate your group health plan. The
summary information we may disclose summarizes claims history, claims expenses
or types of claims those in your group health plan have filed. The summary
information will not include demographic information about the people in the
group health plan, but your employer or plan sponsor may be able to identify you or others
from the summary information.
Underwriting
We may receive your
medical information for underwriting, premium rating or other activities we do
to create, renew or replace a contract of health insurance or health benefits.
We will not use or further disclose this medical information for any other
purpose (except as required by law) unless the contract of health insurance or
health benefits is placed with us, in which case we will use and disclose your medical
information as described in this notice.
Disaster
Relief
We may use or disclose your medical information to a public or
private entity authorized by law or by its charter to assist in disaster relief
efforts.
Public Benefit:
We may use or disclose your medical
information as authorized by law for the following purposes that are in the
public interest or benefit:
- As required by law.
- For public health activities, including disease and vital statistic
reporting, child abuse reporting, FDA oversight, and to employers regarding
work-related illness or injury.
- To report adult abuse, neglect or domestic violence.
- To health oversight agencies.
- In response to court and administrative orders and other lawful processes.
- To law enforcement officials in response to subpoenas and other lawful
processes concerning crime victims, suspicious deaths, crimes on our premises,
reporting crimes in emergencies, and to identify or locate a suspect or other
person.
- To coroners, medical examiners and funeral directors.
- To organ procurement organizations.
- To avert a serious threat to health or safety.
- In connection with certain research activities.
- To the military and to federal officials for lawful intelligence,
counterintelligence and national security activities.
- To correctional institutions regarding inmates.
- As authorized by state workers’ compensation
laws.
Health-Related Services
We may use your medical
information to contact you about health-related benefits and services, or about
treatment alternatives. We may disclose your medical information to a business
associate to assist us in these activities.
Marketing
We may use
or disclose your medical information to encourage you to purchase or use a
product or service by face-to-face communication or to provide you with
promotional gifts.
Individual Rights Access
You have the right to inspect or get
copies of your medical information, with some exceptions. You may request that
we provide copies in a format other than photocopies. We will use the format you
request unless it is not practical to do so. To get your medical information,
you must make a request in writing. If you request
copies, we will charge you $0.50 for each page and for staff time to copy your
medical information. We also will charge for postage if you want us to mail the
copies to you. If you request another format, we will charge a cost-based fee
for providing your medical information in that format. Contact us using the
information listed at the end of this notice for a full explanation of our
fees.
Disclosure Accounting
You have the right to request, in
writing, to receive a list of instances in which we (or our business associates)
disclosed your medical information for purposes other than treatment, payment and
health care operations, or as authorized by you, or for certain other activities allowed by law,
on or after April 14, 2003. We will provide you with the date on which we made
each disclosure, the name of the person or entity to which we disclosed your
medical information, a description of the medical information we disclosed and the
reason for the disclosure. If you request this
accounting more than once in a 12-month period, we may charge you a reasonable,
cost-based fee for each additional request. Contact us using the
information listed at the end of this notice for a full explanation of our
fees.
Restriction
You have the right to request, in writing, that
we place additional restrictions on our use or disclosure of your medical
information. We are not required to agree to these additional restrictions, but
if we do, we will abide by our agreement (except in an emergency). Any agreement
to additional restrictions must be in writing signed by a person authorized to
make such an agreement for us. We will not be bound unless our agreement is in
writing.
Confidential Communications
You have the right to
request, in writing, that we communicate with you about your medical information by other
means or to other locations. You must state that you could be in danger
if we do not communicate to you in confidence. We must accommodate your request if it is reasonable,
if it specifies the other means or location, and if it permits us to continue to
collect premiums and pay claims under your health plan. This includes sending
explanations of benefits to the named insured of your health plan. We will not be bound to
your confidential communications request unless our agreement is in writing.
Even
though you requested that we communicate with you about your health care in
confidence, an explanation of benefits issued to the named insured for
health care that the named insured (or others covered by the health plan) received might contain
sufficient information, such as deductible and out-of-pocket amounts, to reveal that you obtained
health care for which we paid.
Amendment
You have the right
to request, in writing, that we amend your medical information. Your request must explain
why we should amend the information. We may deny your
request if we did not create the information you want amended and the person or
entity that did create it is available, or we may deny your request for certain
other reasons. If we deny your request, we will send you a written explanation.
You may respond with a statement of disagreement that we will add to the
information you wanted to amend. If we accept your request to amend the
information, we will make reasonable efforts to inform others of the amendment, including people
you name, and to include the changes in any future disclosures
of that information.
Electronic Notice
If you receive this notice
on our Web site or by electronic mail (e-mail), you may request this notice in
written form. Please contact us using the information listed at the end of this
notice to request this notice in written form.
Questions and Complaints
If you want more information about
our privacy practices, or if you have questions or concerns, please contact us using the
information below.
If you think we may have violated your privacy
rights, or you disagree with a decision we made about your privacy rights, you
may tell us using the contact information listed below. You also may submit a
written complaint to the U.S. Department of Health and Human Services. We will provide
you with that address upon request.
We support your right to the privacy
of your medical information. We will not retaliate in any way if you choose to
file a complaint with us or with the U.S. Department of Health and Human
Services.
Contact Information
Companion Life
Bruce Honeycutt, Privacy Officer
I-20 @ Alpine Road (AX-E01)
Columbia, SC
29219
(803) 264-7258 (telephone)
(803) 264-7257 (fax)
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